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prior authorizations

Prior authorization kicks in for two complex rehab codes

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03/07/2017

WASHINGTON – CGS and Noridian on March 6 began accepting prior authorization requests for K0856 and K0861 for providers in Illinois, West Virginia, Missouri and New York. They are accepting requests for dates of delivery on or after March 20.

The year in HME News stories

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12/30/2016

YARMOUTH, Maine – 2016 was the year that HME providers fought back.

CMS ready to roll with prior authorizations

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12/31/2015

BALTIMORE – CMS is moving forward with its plans to implement a prior authorization process for certain DME and stakeholders say it should make life easier for providers.

CMS publishes prior auth rule

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12/29/2015

BALTIMORE – CMS today issued a final rule that would establish a prior authorization process for certain durable medical equipment.

Managed care mess: Providers struggle with new reality of serving Medicaid recipients

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10/16/2015

YARMOUTH, Maine – The increasing number of states turning to managed care to run their Medicaid programs is creating a logistical nightmare for providers.

‘Pressure’ is on to expand prior auths

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08/07/2015

YARMOUTH, Maine – CMS recently extended a demo requiring prior authorizations for certain power mobility devices, and providers say it may be time to consider other product categories, too.

Blackburn’s bill seeks to expand prior authorizations

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05/26/2015

WASHINGTON – Rep. Marsha Blackburn, R-Tenn., introduced a bill last week that would require prior authorizations for high-dollar DME.

CMS schedules special forum on PMD demo

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08/05/2014

WASHINGTON – CMS will host a Special Open Door Forum on Aug. 12 to allow DMEPOS suppliers and others to ask questions about the expanding PMD demon.

CMS announces Oct. 1 start date for PMD demo expansion

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07/29/2014

WASHINGTON – CMS will expand its PMD demonstration to 12 additional states on Oct. 1, the agency announced in a final rule published this week.

Stakeholders say prior auths need to be timely, efficient

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05/30/2014

WASHINGTON – Although industry stakeholders are still combing through a plan to implement a prior authorization (PA) process for certain DME, they think it could be a good thing—with a few caveats.

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